Diagnosis and management of Guillain-Barré syndrome in ten steps

Leonhard, S. E. et al. (2019) Diagnosis and management of Guillain-Barré syndrome in ten steps. Nature Reviews Neurology, 15, pp. 671-683. (doi: 10.1038/s41582-019-0250-9) (PMID:31541214) (PMCID:PMC6821638)

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Abstract

Guillain-Barré syndrome (GBS) is a rare, but potentially fatal, immune-mediated disease of the peripheral nerves and nerve roots that is usually triggered by infections. The incidence of GBS can therefore increase during outbreaks of infectious diseases, as was seen during the Zika virus epidemics in 2013 in French Polynesia and 2015 in Latin America. Diagnosis and management of GBS can be complicated as its clinical presentation and disease course are heterogeneous, and no international clinical guidelines are currently available. To support clinicians, especially in the context of an outbreak, we have developed a globally applicable guideline for the diagnosis and management of GBS. The guideline is based on current literature and expert consensus, and has a ten-step structure to facilitate its use in clinical practice. We first provide an introduction to the diagnostic criteria, clinical variants and differential diagnoses of GBS. The ten steps then cover early recognition and diagnosis of GBS, admission to the intensive care unit, treatment indication and selection, monitoring and treatment of disease progression, prediction of clinical course and outcome, and management of complications and sequelae.

Item Type:Articles
Additional Information:C.A.P., C.S., M.L.B.F., M.R.M., and S.E.L. are supported by a grant from the European Union (Horizon 2020, ZikaPLAN Grant Agreement No. 734584). H.J.W. is supported by a grant from the European Union (Horizon 2020, ZikaPLAN Grant Agreement No. 734584) and by the Wellcome Trust Foundation. B.C.J. is supported by a grant from the European Union (Horizon 2020, ZikaPLAN Grant Agreement No. 734584) and has received funding from Prinses Beatrix Spierfonds and GBS/CIDP Foundation International. F.d.A.A.G. is supported by a grant from the Conselho Nacional de Desenvolvimento Científico e Tecnológico. D.R.C. is on the Board of Directors for the Peripheral Nerve Society. P.A.v.D. received a grant from the Prinses Beatrix Foundation for the SID-GBS randomized controlled trial. S.K. is supported by a grant from the Ministry of Education, Culture, Sports, Science and Technology of Japan (Grants-in-Aid for Scientific Research, 18H02745) and the Ministry of Health, Labour and Welfare of Japan (Health and Labour Sciences Research Grant). N.S. is supported by grants from the Malaysian Ministry of Education (FP043-2018A) and ALS Association. T.U. is supported by a grant from the GBS/CIDP Foundation International. E.M.Y. is supported by a grant from the National Health and Medical Research Council of Australia (Early Career Fellowship).
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Willison, Professor Hugh
Authors: Leonhard, S. E., Mandarakas, M. R., Gondim, F. A.A., Bateman, K., Ferreira, M. L.B., Cornblath, D. R., van Doorn, P. A., Dourado, M. E., Hughes, R. A.C., Islam, B., Kusunoki, S., Pardo, C. A., Reisin, R., Sejvar, J. J., Shahrizaila, N., Soares, C., Umapathi, T., Wang, Y., Yiu, E. M., Willison, H. J., and Jacobs, B. C.
College/School:College of Medical Veterinary and Life Sciences > Institute of Infection Immunity and Inflammation
Journal Name:Nature Reviews Neurology
Publisher:Nature Publishing Group
ISSN:1759-4758
ISSN (Online):1759-4766
Published Online:20 September 2019
Copyright Holders:Copyright © 2019 The Authors
First Published:First published in Nature Reviews Neurology 15:671-683
Publisher Policy:Reproduced under a Creative Commons License

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